Larson P J, Lukas M B, Friedman D F, Manno C S
Department of Pediatrics, University of Pennsylvania, Philadelphia, USA.
Am J Hematol. 1996 Dec;53(4):248-50. doi: 10.1002/(SICI)1096-8652(199612)53:4<248::AID-AJH8>3.0.CO;2-Y.
Go(a) (D(Cor)) is a low-frequency antigen in the Rh system found on red cells lacking part of the D mosaic (category IVa). Anti-Go(a) has not been previously reported to cause hemolytic transfusion reactions. A 27-year-old African American male with sickle-cell disease, maintained on chronic transfusion, was noted to have dark plasma during an erythrocytapheresis, procedure, and the pretransfusion hemoglobin was noted to be 1 g/dl lower than 4 weeks before (with hyperbilirubinemia and a significantly increased LDH). Polyspecific direct antiglobulin test (DAT) was weakly positive (C3-weak, IgG-weak), and indirect antiglobulin tests (IATs) performed on the serum (pre- and posttransfusion reaction) and a red blood cell (RBC) eluate from the postreaction sample were negative. A segment from one of the four implicated units from the prior month's transfusion was strongly reactive at 37 degrees C and using anti-human globulin (AHG) when crossmatched with the postreaction serum and the eluate. The postreaction serum, screened with a panel of red cells positive for low-prevalence antigens, reacted with three Go(a+) cells. The implicated unit was reactive with a previously identified anti-Go(a) serum.
Go(a) (D(Cor))是Rh系统中的一种低频抗原，存在于缺乏部分D镶嵌结构的红细胞上（IVa类）。此前尚未有抗Go(a)引起溶血性输血反应的报道。一名27岁患有镰状细胞病的非裔美国男性，长期接受输血治疗，在一次红细胞单采过程中发现血浆颜色变深，且输血前血红蛋白比4周前低1 g/dl（伴有高胆红素血症和乳酸脱氢酶显著升高）。多特异性直接抗球蛋白试验（DAT）弱阳性（C3弱、IgG弱），对血清（输血前后反应）和反应后样本的红细胞洗脱液进行的间接抗球蛋白试验（IAT）均为阴性。与反应后血清和洗脱液交叉配血时，前一个月输血所涉及的四个单位之一的一段血液在37℃下使用抗人球蛋白（AHG）时呈强反应性。用一组低频率抗原阳性的红细胞进行筛查时，反应后血清与三个Go(a+)细胞发生反应。所涉及的单位与先前鉴定的抗Go(a)血清发生反应。
